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Improving DoD to VA Health Care Transitions through Clinical Care

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*** CCM, RN and SW hours ***
Originally presented at 2021 Annual Conference

Transitions between health care organizations inherently introduce safety risks to Service members and Veterans. Every health care system is challenged with developing strategies to provide effective transitions of care. The one-year period following when a Service member leaves the military is a time when risks are heightened and disassociation from care is all too common. To mitigate against these challenges, the Real Warriors Campaign (RWC), inTransition, VA Liaison Program, and VA Transition and Care Management (TCM) Program apply a systems-based approach to enhancing the quality and safety of transitions of care for recently separated Veterans. Through proactive communication, the DoD and VHA work together to decrease intrapersonal and systemic barriers to accessing health care. RWC is a DoD-centric, nationwide, anti-stigma and education campaign and inTransition is a DoD policy-mandated program with individual coaches using goal-setting and Motivational Interviewing to assist transitioning Service members and Veterans. VA Liaisons embedded at or virtually supporting DoD installations and VA TCM teams at VA medical centers facilitate transitioning Service members and recently separated Veterans access to VA health care and ongoing case management services. Through relationship building and purposeful collaboration, the programs work in concert to provide seamless transitions of care from the DoD to VA. This interorganizational collaboration utilizes different practice disciplines to create a formalized referral process by which Service members and recently separated Veterans are made aware and educated about seeking health care. Through coaching, educating, advocating, and care coordinating, these programs help bridge the gap between two federal organizations, and ensure Service members and Veterans are supported and welcomed into the VHA by case management professionals who stand ready to serve them.

OBJECTIVES:
  1. Identify key benefits to receiving transition services from DoD to VHA.
  2. Discuss challenges associated with accessing care during the first year following military separation.
  3. Discover one way in which the DoD and VHA are partnering to improve the transition experience for Service members and Veterans.